Li Guozhi, Liu Hao, Pan Zhiyuan, Cheng Li, Dai Jiewen
Department of Oral and Cranio-Maxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; College of Stomatology, Shanghai Jiao Tong University, Shanghai, China; National Center for Stomatology, Shanghai, China; National Clinical Research Center for Oral Diseases, Shanghai, China; Shanghai Key Laboratory of Stomatology, Shanghai, China.
Department of Oral and Cranio-Maxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; College of Stomatology, Shanghai Jiao Tong University, Shanghai, China; National Center for Stomatology, Shanghai, China; National Clinical Research Center for Oral Diseases, Shanghai, China; Shanghai Key Laboratory of Stomatology, Shanghai, China.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2025 Mar;139(3):364-376. doi: 10.1016/j.oooo.2024.11.002. Epub 2024 Nov 12.
This study aimed to develop 3 models based on computed tomography (CT) images of patients with craniofacial fibrous dysplasia (CFD): a radiomics model (Model Rad), a deep learning (DL) model (Model DL), and a hybrid radiomics and DL model (Model Rad+DL), and evaluate the ability of these models to distinguish between adolescents with active lesion progression and adults with stable lesion progression.
We retrospectively analyzed preoperative CT scans from 148 CFD patients treated at Shanghai Ninth People's Hospital. The images were processed using 3D-Slicer software to segment and extract regions of interest for radiomics and DL analysis. Feature selection was performed using t-tests, mutual information, correlation tests, and the least absolute shrinkage and selection operator algorithm to develop the 3 models. Model accuracy was evaluated using measurements including the area under the curve (AUC) derived from receiver operating characteristic analysis, sensitivity, specificity, and F1 score. Decision curve analysis (DCA) was conducted to evaluate clinical benefits.
In total, 1,130 radiomics features and 512 DL features were successfully extracted. Model Rad+DL demonstrated superior AUC values compared to Model Rad and Model DL in the training and validation sets. DCA revealed that Model Rad+DL offered excellent clinical benefits when the threshold probability exceeded 20%.
Model Rad+DL exhibits superior potential in evaluating CFD progression, determining the optimal surgical timing for adult CFD patients.
本研究旨在基于颅面部骨纤维异常增殖症(CFD)患者的计算机断层扫描(CT)图像开发3种模型:一种放射组学模型(模型Rad)、一种深度学习(DL)模型(模型DL)以及一种放射组学与DL混合模型(模型Rad+DL),并评估这些模型区分病变处于活动进展期的青少年和病变处于稳定进展期的成年人的能力。
我们回顾性分析了上海第九人民医院治疗的148例CFD患者的术前CT扫描图像。使用3D-Slicer软件对图像进行处理,以分割并提取用于放射组学和DL分析的感兴趣区域。使用t检验、互信息、相关性检验以及最小绝对收缩和选择算子算法进行特征选择,以开发这3种模型。使用包括从受试者工作特征分析得出的曲线下面积(AUC)、灵敏度、特异度和F1分数等测量指标评估模型准确性。进行决策曲线分析(DCA)以评估临床获益。
总共成功提取了1130个放射组学特征和512个DL特征。在训练集和验证集中,模型Rad+DL的AUC值优于模型Rad和模型DL。DCA显示,当阈值概率超过20%时,模型Rad+DL具有出色的临床获益。
模型Rad+DL在评估CFD进展、确定成年CFD患者的最佳手术时机方面具有卓越潜力。